Provider Demographics
NPI:1396117073
Name:PRICE, AIMEE (DOM)
Entity type:Individual
Prefix:
First Name:AIMEE
Middle Name:
Last Name:PRICE
Suffix:
Gender:F
Credentials:DOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1090 CANYON RD
Mailing Address - Street 2:
Mailing Address - City:LOS ALAMOS
Mailing Address - State:NM
Mailing Address - Zip Code:87544-2956
Mailing Address - Country:US
Mailing Address - Phone:505-412-8246
Mailing Address - Fax:
Practice Address - Street 1:1090 CANYON RD
Practice Address - Street 2:
Practice Address - City:LOS ALAMOS
Practice Address - State:NM
Practice Address - Zip Code:87544-2956
Practice Address - Country:US
Practice Address - Phone:505-412-8246
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-21
Last Update Date:2015-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1180171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist